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Big Time Hustler —

Trigger warning: This post is all about the well-documented failure of weight loss and the pathetic attempts to gloss over that reality.

You know weight loss doesn’t work. You’ve heard the stat: 95% of weight loss attempts fail within five years, and the dieter regains most, if not all, of the weight. And many people end up putting on more weight as a result.

When you read the research, it’s clear that obesity researchers are aware that long-term weight loss is a near impossibility and that we have no long-term solutions for the fatties.

When you talk to anyone who still believes in calories in/calories out about the 95% failure rate of weight loss, that person will readily accept the truth of the statistic (as MeMe Roth did in my interview with her), then attempt to reconcile that fact with their own deeply cherished beliefs about healthy lifestyles.

And these people who desperately want us to believe that weight loss is still possible, despite all the evidence to the contrary, will inevitably say the one thing that the research on weight loss failure isn’t commenting on because it’s such an obvious statement: fad diets don’t work.

“Diets fail because people want a quick fix,” we’re assured. “It takes hard work and commitment, and most people aren’t willing to do that.”

First off, there are very few truly “revolutionary” methods for weight loss. All weight loss programs prescribe some form of caloric deficit, either through decreased caloric consumption, increased caloric expenditure or both. Your caloric deficit depends on how much weight you want to lose.

What distinguishes the various programs is the macronutrient balance prescribed. Some emphasize restricting carbohydrates (e.g., Atkins, South Beach), while others emphasize restricting fats (e.g., Ornish, Pritikin). As far as I know, there is no commercial weight loss program that emphasizes a low-protein diet, though a vegetarian, or vegan, diet does eliminate animal protein as a source. Dr. Joel Fuhrman leans toward low protein as part of his plan, but Furhman’s research is sketchy at best, as I explained in my post on the faddish juicing diet from Fat, Sick, & Nearly Dead.

There’s one final option, and the one most often cited as the “alternative” to all those failed, fad diets: eat less, move more.

Yes, all those other hoity-toity prescriptions have failed to emphasize that it’s not how you eat, but how much you eat and how much you move. Even Weight of the Nation addresses, then dismisses, the failure of weight loss programs by suggesting that eat less, move more is the solution to all our weight woes.

Brownell is widely respected for his work on obesity and health, and goes about halfway there in promoting the idea that weight loss is nearly impossible for most Americans. If anyone is helping to deconstruct the myth of long-term weight loss, it’s Brownell.

But as I explained in this recent post, the LEARN program has even less impressive long-term results than Atkins.

That means that after two years of following the EatRight program, they had lost nine pounds of their body weight, or 5% of their starting weight. And this is simply the mean. Consider those who weigh significantly more, say 300 pounds instead of 200. Five percent of 300 pounds is 15 pounds, or an ending weight of 285 pounds… still fat by mainstream standards.

So, no, eat less, move more is not somehow magically exempt from the 95% failure rate.

But that doesn’t stop researchers from spin, spin, spinning the data to suggest otherwise.

Perfect example: a 2010 article in the International Journal of Obesity looked specifically at “long-term” and walked away with this cheery conclusion:

More than one out of every six US adults who has ever been overweight or obese has accomplished [long-term weight loss maintenance (LTWLM)] of at least 10%. This rate is significantly higher than those reported in clinical trials and many other observational studies, suggesting that US adults may be more successful at sustaining weight loss than previously thought.

Well, goodness gracious me… we’ve been disproven, folks. One in six fatties has lost at least 10% of their starting weight and kept it off for the long term. Nevermind all that negativity and pessimism, let’s celebrate the good news!

But just one thing before we break out the party hats… how do the numbers actually break down:

Among US adults who had ever been overweight or obese, 36.6, 17.3, 8.5 and 4.4% reported LTWLM of at least 5, 10, 15 and 20%, respectively.

Ah, so 17.3% maintained a weight loss of at least 10%, while just 4.4% maintained a weight loss of 20% or more. But it’s long-term, right? So, that’s awesome!

Except… well, “long-term” in this study is defined as a maintenance of one year after achieving their goal weight. Oh, and those aged 75 to 84 were 1.5 times more likely to have lost 10% or more than those aged 20-34. Also, 31% who those who reported losing at least 10 pounds the previous year said it was unintentional.

So, let’s crunch the numbers, shall we?

This research was based on the National Health and Nutrition Examination Survey (NHANeS) data, which is the most solid research data in my opinion (check out my interview with lead author Dr. Katherine Flegal, who explains the strength importance of NHANES).

According to NHANES, in 2010 69.2% of the adult population over the age of 20 had a BMI over 25 (aka, overweight or obese). According to 2010 Census data (PDF), there were 219,985,000 people over the age of 20. Therefore, in 2010, there were 152,229,620 overweight or obese people in the United States.

To grossly oversimplify this in terms that benefit the weight loss industry, let’s say that every one of the overweight or obese people weighed 250 pounds. Anyone who weighs 250 pounds and is shorter than 6’4″ would be overweight and the rest would be obese. So in terms of how the percentage of weight lost translates into actual pounds, this assumption is weighted heavily to favor the impressive results of long term weight loss.

Now, to break that down even further, the amount of people who lost weight and kept it off for at least one year are as follows:

5%, or 13 pounds — 56 million people

10%, or 25 pounds — 26 million people

15%, or 38 pounds —13 million people

20%, or 50 pounds or more —7 million people

But of the roughly 46 million people who lost 10% or more, one-third did so unintentionally, which leaves 32 million people who were able to lose 10% or more and keep it off for a year. When you factor in intentionality, that leaves 11.8%, 5.9%, and 3.2% of fatties who lost 10%, 15% and 20% of their weight on purpose.

I have no idea how to even account for that fact that significant weight loss occurred with greatest frequency among the oldest fatties.

And all of this depressing information is after just one year of maintenance. The 95% axiom refers to five years after achieving weight loss.

The further a person gets from achieving his or her weight loss goal, the more weight they regain.

So I can only shake my head at this sad attempt at portraying long-term weight loss as proof that “US adults may more successful at sustaining weight loss than previously thought.”

And when you take a step back from the statistical manipulations, you find an even more disturbing pattern in how pop culture interprets these results. For example, I came across an article in Yahoo! News titled “Signs of False Diet Advertisements.”

Now, I realize you’re probably thinking “Who the hell reads Yahoo! News?” but I still get links from people who Google “failed weight loss” and point to articles like this as a “rebuttal” to the research. It begins promising enough:

False diet advertisements are actually more common than you think. In fact, probably at least half of all of the diet advertisements that you see when you open up just about any magazine probably provide false claims.

You know you’re on solid ground when the author begins a claim by saying “In fact, probably at least half of all…”

Let me try that… It is absolutely true that most likely at least two-thirds of statistics are bullshit.

Do people even understand that by saying “In fact” you’re setting up people to read a fact?

But the author gives five suggestions to help people spot misleading weight loss ads:

Claims of Unrealistic Potential Weight Loss

Claims that You No Longer Need to Diet to Lose Weight

Claims that You Don’t Need to Exercise to Lose Weight

Claims that Others Have Lost Significant Amounts of Weight

Claims that the Product Will Lead to Permanent Weight Loss

So, here we have an article that purports to clear away the cobwebs of confusion as to the source of weight loss failure. The author even acknowledges that eat less, move more isn’t perfect:

Claiming that a product will lead to permanent weight loss is just a complete and total lie. There is no such product out there. If there was, do you think that there would be so many people who are overweight? Diet, exercise and maintain a healthy lifestyle are the best ways to keep your weight off, but none of these ways are even permanent.

Fairly even-handed, but the emphasis is still on the fact that “fad” diets lead to weight loss failure, while diet and exercise are more successful, when the research shows that ALL attempts at weight control are equally pathetic.

But here’s what really caught my eye, in the first item on unrealistic weight loss goals:

If a certain product or diet claims that you will lose 20 pounds in just four days, you should know that the product is false advertising. A realistic weight loss goal would be losing five pounds in a week — not twenty pounds in a week. [emphasis mine]

Those weight loss ads that are so dishonest? Yeah, most of them are making the FTC-friendly claim that their product will lead to 1-2 pounds per week. The only weight loss products that even suggest a 5 pound weight loss are the very low calorie diets, which range from 800 to 1,200 calories per day, and even their ads say you’ll lose between 2 to 5 pounds per week.

And this is par for course in how the media covers these issues… they acknowledge the facts (“Long-term weight loss doesn’t work!”) then spew a dozen other “facts” that are specious at best, downright dishonest at worst (“A realistic goal is five pounds per week!”)

This is also what happens in Weight of the Nation, where experts like Brownell explain how difficult and rare long-term weight loss is, then the director spends an entire one-hour episode touting the various methods that somehow supersede this reality.

But there is no getting around the stone, cold fact that long-term weight loss is unrealistic for the vast majority of us. And by “long-term” I mean the rest of your life, since that is the ultimate goal of weight loss, right? It’s not just to lose the weight, but to then maintain that healthy weight until you die at the ripe old age of 105.

So, when you hear an “expert” respond to the criticism that weight loss doesn’t work, remember that there is no exception, there is no silver lining, there is no method that bypasses this reality. Nobody knows an approach to weight loss that can produce the kind of spectacular results that are necessary to “reverse” our current obesity trends.

I had seen the very first episode they did, then the other day I watched all four episodes that had to do with weight, obesity and muscle composition. I’m planning to do a post on them, but I want to rewatch them first. I think they are incredibly valuable.

I’d like to know more about the older people who unintentionally lost weight, too. I wonder if they went through a physiological change. Also, the concept of unintentional weight loss makes me wonder how many of the people who intentionally lost weight actually lost weight unintentionally.
What I mean is, if somebody happened to be on a diet at the same time as a mysterious weight loss inducing event happened, then they would attribute the weight loss to the diet.

I don’t think there’d be any way to tease out that relationship because these are all based on phone surveys. Plus, appetite and hunger are driven by leptin and if something triggers an increase in circulating leptin, you wouldn’t be as hungry. You may chalk that up to self-control, but there’s more to the story than will power. It’s far too complicated to be able to study that relationship, though I suspect it’s there in a sliver of the cases. But what boggles my mind is that the media reports these findings without mentioning that one-third was unintentional weight loss! That’s HUGE! And in any case, one year is a pittance. Five year studies dwarf this nonsense.

Jimmy,
Before you comment, you should read our comment policy. Your last comment violated our Clear and Present Asshole Rule. If you want to insult and demean our readers, you’ll have to find a different forum. If you want to challenge our beliefs, we invite you to do so respectfully.

Now, perhaps you have lost 50 pounds, but I would point out that in your last comment that you said you “had my ups and downs” with regard to your weight. Depending on how big those “ups and downs” were, you may have been weight cycling, which negatively affects cardiovascular health, long-term mortality and weight gain. Most fat people have not shared your experience of losing weight and keeping it off, and it isn’t because they’re lazy or unmotivated. Any of our readers can tell you what they have tried, and how their body has responded briefly with weight loss, only to stop all together.

Now, you can throw out all the great weight loss advice you can think of, but we’ve heard it all and tried it all, and the overwhelming research supports the idea that MOST people aren’t able to lose 50 pounds and keep it off. The research also shows this isn’t necessary for health. Healthy behaviors are, but whether that leads to weight loss is a moot point.

As far as your previous comment mentioning how 150 years ago people were far less fat because of the difference in food and labor, this is partially true. But if you somehow think that food insecurity and manual labor are the answers, you’re wrong. It’s not that people 150 years ago were more virtuous as evidenced by their dietary temperance. They didn’t have a choice. Once you introduce choice, then the equation changes. Same goes for labor. People weren’t doing back breaking labor because they wanted to stay thin, they had no choice. Today, in order to maintain the same level of physical exertion, people have to work out ON TOP OF their 9-5 jobs. So, these two choices alone are tilted in favor of a heavier population.

But there were also radical shifts in how our society responded to increasing weights. For the first time in history, we encouraged everyone to lose weight and people did as they were told, only to get heavier and heavier between 1980 and 1999. Obesity rates leveled off and we’ve been there ever since. So, there have been environmental factors that have contributed to increased obesity rates, but this is hardly surprising given the changes in society.

So, if you are looking for us to respond to your simplistic explanation with “Oh gee, you’re right, why didn’t we think of that” you’re going to be sorely disappointed. And if you intend to make an obnoxious ass of yourself, you can expect us to be as “cute” as to ban your ass from our forum. If you want to debate, bring a debate, but don’t go all hardcore dickweed and expect us to honor your presence. We’ve battled bigger trolls than you, my friend, and we have little tolerance for willful ignorance and hatred.

Thin since when?
And why would you prefer being thin to being of optimal weight? Thin is physically less healthy than overweight (regarding populations).
It’s possible for most people to lose a fair amount of weight, just like it’s possible to do without sufficient sleep for a period of time. But it’s going to take its toll in the long run, again, for most people.

Doesn’t this just mean that it’s more important to prevent children from gaining weight in the first place? If obesity or being overweight is a major problem, the emphasis should be on prevention, not on quick fixes, IE you can have a car with brakes or airbags, but not both. The logical choice would be the preventative measure.

Firstly, children always gain weight, they are growing. Preventative measures in my mind are useless, if they’re going to assume that every single child is meant to be this healthy size as a thin adult, as this is quite clearly not the case. By all means, promoting healthy behaviors among children is great, but you are conflating weight with health. There are many people above a 25 on the BMI scale, above a 30, above a 35, that are healthy and active adults. There are many people with a BMI less than 30, less than 25, that live sedentary lives and partake in any number of unhealthy behaviors that degrade their health.

James,
The problem is that there have always been fat kids and that the traditional way pediatricians looked at a child’s weight was in terms of the growth trajectory, not simply the BMI of the child, as I explain in this post. So, if by “prevention” you mean we should round up all the fat kids and make them thin, I’m not with you in the least. But if you mean that we should be encouraging healthy behaviors in ALL children, regardless of their size, then you’ve got my support.

If a child is born in the 95th percentile and spends the majority of their youth in the 95th percentile, there is nothing to “prevent.” Some kids are just bigger than others. What I, personally, want to prevent is teaching kids that being fat is the worst thing you can be, and that eating healthy and exercising are tools for getting, or remaining, thin. Weight is more complicated than prevention. What about the boy who is put on anti-depressants and has weight gain as a side effect, despite little change in their lifestyle? What about the girl who puts on weight prior to puberty, and her mom puts her on a diet in response? What about the child who has always been fat, but would have grown out of it if her parents hadn’t drilled the importance of weight loss above and beyond good nutrition and fulfilling movement?

So it all depends upon your definition of “prevention” and what exactly you want to “prevent.” I want to prevent an entire generation of children with eating disorders. I also want to prevent another generation of fat kids who are made to feel like crap because they don’t look the way others think they should. Eating healthy and exercising can be a part of that, in my opinion, but not if it’s used in an unhealthy or counter-productive way.

Sugar and carb addictions. Depression. Addiction and depression. Chemical additives that encourage overeating, for example MSG. MSG is hidden in 80% of processed food via different nomenclature. Diets do not compensate for the behavioral and chemical aspects of food. What happens when you are addicted to something? —> You need more and more to get the same feel-good high.

Nope, I’m saying that if you eat healthy, exercise and don’t lose a ton of weight, that you shouldn’t feel disappointed and give up those habits because weight loss is not the important outcome. Bloods pressure, blood sugar and blood lipids are. Focus on those and a healthy lifestyle and stop putting so much emphasis on weight loss.